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Bladder, Bowel & Belly: Expert Advice On Your Post-Baby Body

Having a baby causes many changes to your body. Some of these changes will gradually return to normal, but others may need some help. The most important thing is to be patient with your body in the weeks and months following the arrival of your little darling, advises physiotherapist Aoibhin McGreal.

See the post-natal checklist below for some of the common problems that may require that extra help.

If you answered ‘yes’ to any of the questions above, you should contact a chartered physiotherapist who specialises in women’s health and continence, as all of these conditions are treatable.

Your bladder after baby

Some women will notice that their bladder control is reduced following pregnancy and delivery. You may find that you can’t ‘hold on’ when you need to go to the toilet or that you leak when you laugh, cough or sneeze. This can be due to weakness of the pelvic floor muscles as a result of the way baby’s head stretches these muscles during delivery.

It is really important to start gentle pelvic floor exercises as soon as possible to improve bladder control and to increase muscle support around your pelvis. Sometimes bladder problems may also be due to the pelvic floor muscles being tight and tense, so ensuring that the muscles relax completely is also hugely important.

If you continue to experience decreased bladder control for longer than six weeks after delivery, you should arrange an assessment with a chartered physiotherapist in women’s health and continence who will assess your pelvic floor muscles and advise you on a suitable treatment plan.

Your bowel after baby

This is one of the problems that not many women talk about, but some women may notice that their bowel control is reduced after having a baby. So why does this happen? The pelvic floor muscles are vital for bowel control, and can be stretched and weakened during childbirth.

If you have a tear during delivery, this can further damage the pelvic floor muscles and, depending on the degree of the tear, the muscle in your back passage (the anal sphincter) may also be damaged.

This can obviously be a very embarrassing problem, but for many women specialised physiotherapy to strengthen these important muscles leads to great results, so don’t despair.

That dragging feeling ‘down there’

After having a baby, some women may have a dragging feeling ‘down there’ or even be able to see something coming out of the vagina. This is normally due to a weakness of the vaginal walls and is quite common after childbirth.

If you are suffering from this, it is advisable to avoid doing things that increase the pressure on the pelvic floor, such as standing for long periods, stooping down and lifting heavy weights. It is also advisable to avoid getting constipated and having to strain.

In addition to avoiding these aggravating factors, specialised physiotherapy to strengthen the pelvic floor muscles can help by increasing the support to the vaginal walls. The earlier you start the better, so don’t suffer in silence!

Your belly after baby

This is the one area that many of my patients worry about. The skin and muscles over your bump have stretched to allow your baby to grow and develop over the past nine months, and it can take weeks to months for the tummy to lose its saggy look.

One new mum recently told me that her tummy muscles were 'completely gone' and, although it may feel like that is the case, fear not, they are still there. Muscles can’t ‘go’ anywhere, but your abdominals can become very weak during pregnancy and if you have a Caesarean section, this can weaken them further.

If you notice a gap in your tummy muscles that does not gradually close following the birth of your baby, you may have a condition called diastasis rectus abdominus. If this gap has not closed six weeks after delivery, it is unlikely to heal on its own and so it would be advisable to arrange an assessment with a chartered physiotherapist in women’s health and continence.

Make sure to avoid sit upsand other advanced core exercises such as the plank or double leg lifts until you have strengthened your deep abdominals and pelvic floor muscles. Start with some gentle abdominal exercises by drawing your lower tummy in towards your spine, holding for 10 seconds while breathing gently, and repeat 10 times.

Your back after baby

Many new mums have back or pelvic girdle pain. This is often due to a combination of factors, including weak abdominals and glutes (buttocks), tightness or trigger points in the muscles of the back and buttocks and problems with posture.

It is important to note that back and pelvic girdle pain differs from person to person, that is why an assessment of your posture, movement and strength is needed to identify the cause.

Treatment with a chartered physiotherapist may include manual therapy, exercises and advice on techniques and positions for carrying, feeding and changing baby to minimize the discomfort.